EXPANDING THE ENGAGEMENT OF OLDER PERSONS IN CLIMATE CHANGE ACTION

Abstract Environmental volunteerism and civic engagement have been found to promote physical and mental well-being among older adults as well as helping communities address environmental issues. Despite the growing need for citizen action to address disasters and other climate change effects, however, little is known about how to promote such engagement. At present, few climate change organizations actively recruit or provide specific opportunities for older persons. Academics and policymakers have focused on how older people are particularly susceptible to the impact of climate change. Limited attention has been paid, however, to the ways in which older people can be actively involved on their own behalf in climate change mitigation, including engagement in disaster preparation and response. In this presentation, I review barriers to widespread mobilization of older adults in climate change action, including their lower levels of environmental concern and their systematic lack of access to opportunities for climate change activism. I report on findings from a recent international survey of local and regional organizational efforts to engage older persons in climate change prevention and mitigation. This survey identified successful models for mobilizing older persons to address climate change mitigation, and in particular in low- and middle-resource countries. Recommendations for effective program design to bring older persons more fully into climate change action are presented, as well as ways environmental organizations can expand their focus to include systematically older persons in their activities.

population of older, medically complex, individuals residing at home, and an increased frequency of severe natural disasters creates a compounded burden on local communities to reduce potential harm to these community-dwelling members during disaster response and recovery.In response, the Veterans Health Administration (VHA) established the Vulnerable Patient Care, Access, and Response in Emergencies (VP CARE) program to provide standardized data tools and guidance to assist VA medical facilities in conducting outreach to and care coordination of medically frail and older Veterans during major emergencies.VP CARE utilizes geographic information system (GIS) tools to allow outreach prioritization based upon geographic proximity to an event and patient clinical needs.In response to Hurricanes Ian and Fiona, the VP CARE team, with the support of the national VEText team, successfully deployed a new 2-way patient texting communication capability.During an emergency, patients receive a text from VEText, are asked whether they require assistance, and the specific help they need.The new VEText capability helped VA staff reduce outreach call volume by 20% and allowed for triage and prioritization of those indicated as needing assistance to the top of the outreach list.This presentation provides an overview of VP CARE approaches and what VHA has learned through its implementation to assist other healthcare systems with establishing similar capabilities.Environmental volunteerism and civic engagement have been found to promote physical and mental well-being among older adults as well as helping communities address environmental issues.Despite the growing need for citizen action to address disasters and other climate change effects, however, little is known about how to promote such engagement.At present, few climate change organizations actively recruit or provide specific opportunities for older persons.Academics and policymakers have focused on how older people are particularly susceptible to the impact of climate change.Limited attention has been paid, however, to the ways in which older people can be actively involved on their own behalf in climate change mitigation, including engagement in disaster preparation and response.In this presentation, I review barriers to widespread mobilization of older adults in climate change action, including their lower levels of environmental concern and their systematic lack of access to opportunities for climate change activism.I report on findings from a recent international survey of local and regional organizational efforts to engage older persons in climate change prevention and mitigation.This survey identified successful models for mobilizing older persons to address climate change mitigation, and in particular in low-and middle-resource countries.Recommendations for effective program design to bring older persons more fully into climate change action are presented, as well as ways environmental organizations can expand their focus to include systematically older persons in their activities.

POLICY SERIES: BUILDING TRUST, ADDRESSING BURNOUT AND EXPANDING THE DIRECT CARE WORKFORCE; THE 2022 REPORT TO DHSS AND CONGRESS
Chair: Naushira Pandya Discussant: Brian Lindberg This symposium will review the key points and recommendations of the 2022 report to the Secretary of DHSS and Congress, prepared by the federally appointed Advisory Committee on Interdisciplinary and Community-Based Linkages in a blended didactic and interactive format.Clinician burnout following the Covid-19 pandemic is examined and root causes identified.Erosion of the patient trust in the public healthcare system and the consequences thereof are discussed, enhanced role of Community Health workers as the future primary care workforce is explored to prepare the system to prepare for future challenges.

WORKFORCE CHALLENGES DURING COVID-19 Joan Weiss, Health Resources and Services Administration (HRSA), Rockville, Maryland, United States
As of October, 2022 nearly 1.1 million individuals in the United States died of COVID-19 with approximately 790,000 being individuals ages 65 and older.This age group accounts for 16% of the total US population but 75% of all COVID deaths to date.Covid-19 has taxed the United States public health system resulting in clinician burnout and a lack of trust in the public health system.The demands of the pandemic physically, psychologically, and logistically overwhelmed many clinicians resulting insomnia, anxiety, depression, and increased risk for substance use and misuse.Burnout at the institutional level is associated with increased medical errors, lower quality of care, and hospital-acquired infections.Compounding the issue of burnout was the lack of public trust that subsequently developed.Facts about COVID-19 competed with misinformation of the disease, false medical cures, contradictory health messages, an overwhelmed health care system in many areas, and conspiracy theories.One solution to these concerns is to increase the use of Community Health Workers (CHC).CHCs are trusted members of the communities they serve and play an essential role in assisting in care, providing factual information, and dispelling misinformation related to health topics such as COVID-19 infection, symptoms, and vaccination.Augmenting this workforce may help the system prepare for future emergencies.This presentation will discuss the recommendations of the Federal Advisory Committee on Interdisciplinary, Community-Based Linkages' latest report "Building Trust, Addressing Burning, and Expanding the Direct Care Workforce".

ALZHEIMER'S DISEASE AND RELATED DEMENTIAS AND HEALTH CARE
Abstract citation ID: igad104.0694

COGNITIVE MISPERCEPTION, DISABILITY, AND MORTALITY AMONG OLDER ADULTS IN 25 COUNTRIES
Zhuoer Lin, Mark Schlesinger, and Xi Chen, Yale University, New Haven, Connecticut, United States Despite a large body of literature on cognitive ability and health, less is known about the health consequences of biased cognitive perception.Using harmonized and nationally representative longitudinal surveys from 25 countries spanning Asia, Europe and the Americas, we document the growing gap between actual and perceived cognitive ability that appears to increase with age, and construct a standardized measure of cognitive misperception.Linking this novel measure with mortality and disability, we model the cognitive misperception -health gradient.Results show that being in the upper quartile of cognitive misperception (i.e., showing heightened overconfidence in cognition) leads to higher mortality rates within 1 year, 3 years, and 5 years.Conditional on survival, being overconfident in cognition also greatly increases the risks of incident disability and frailty, especially for older adults receiving less family support.We identify two possible pathways inducing poorer outcomes: the first stemming from increased risk taking and financial vulnerability; the second associated with suboptimal use of preventive services and declines in health-promoting behaviors.Given the large and profound impacts of cognitive misperception on older adults' health and well-being, more family and social supports, public investment in education and health literacy, and better healthcare access and affordability are needed to increase the timely awareness of cognitive decline.

DISPARITIES IN CONTINUITY OF CARE AND USE OF ANNUAL WELLNESS VISITS AMONG OLDER AMERICANS WITH DEMENTIA Elham Mahmoudi, University of Michigan Medical School, Ann Arbor, Michigan, United States
Working on a risk-adjusted, prospective, capitated payment system, Medicare Advantage (MA) plans are incentivized to offer more efficient and coordinated care than traditional Medicare (TM).This study has two aims: (1) compare the continuity of care and use of annual wellness visits between MA and TM enrollees with Alzheimer's disease and related dementia (ADRD), and (2) examine Hispanic-White and Black-White disparities in the continuity of care and annual wellness visits by comparing MA with TM enrollees with ADRD.We used a 20% random sample of TM andMA insurance claims (2018-2019).Participants included individuals 65+, with a diagnosis of ADRD, and two years of continuous enrollment in TM (n=129,177) or MA (n=119,130).We used the Bice-Boxerman Continuity of Care Index to measure continuity of care.Generalized linear models were applied.TM lowered the odds of Black and Hispanic individuals having an annual wellness visit [OR=.80 (95% CI:.79-.82)].Black and Hispanic TM enrollees had lower odds of annual wellness visits as compared to their Black and Hispanic MA counterparts [OR=.83(95% CI:78-.88) and OR=.88 (95% CI:.83-.94)],respectively.White, Black, and Hispanic MA enrollees had higher continuity of care than their counterparts in TM (27.4 vs. 24.9; 28.9 vs. 28.1; 32.1